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从两个不同角度看泌尿外科住院医师理想培训的定义:受训者与教授。他们对良好培训的看法是否一致?

The definition of ideal training of a urology resident from two different perspectives: trainees vs professors. Is there agreement in their idea of good training?

作者信息

Mantica Guglielmo, Carrion Diego M, Pang Karl H, Ucar Taha, Parodi Stefano, Tappero Stefano, Lazarou Lazaros, Glykas Ioannis, Zabaftis Christos, Lourenco Mario, Padilla Daniel A González, Polledo Luis Enrique Ortega, Paraboschi Irene, Berrettini Alfredo, Terrone Carlo, Rivas Juan Gomez, Esperto Francesco

机构信息

IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy.

出版信息

Cent European J Urol. 2023;76(2):162-166. doi: 10.5173/ceju.2023.019. Epub 2023 Apr 7.

Abstract

INTRODUCTION

At the end of their residency program, urology trainees should reach the minimum skills required to be able to work by themselves and within a team. To achieve this objective, it is fundamental that the training involves not only surgical activities, but also theoretical, academic, and relational ones. What is the perfect balance between these activities within the ideal urological training? This study aims to evaluate the concordance in different concepts of good urological training between different perspectives (trainees vs professors).

MATERIAL AND METHODS

Between January and December 2020 the same survey was distributed via email to 967 urology trainees and urology tutors. The survey investigated 5 educational fields: theoretical, clinical, surgical, relational, and simulation. For each field, specific questions investigated the importance of different activities and the training outcomes considered fundamental to be reached by a resident. The questions were evaluated by responders through a Likert 10-point scale.

RESULTS

The survey was completed by 155 trainees (58.9%, Group A) and 108 tutors (41.1%, Group B) from 26 different countries. Relative to the tutors, residents assigned statistically significantly lower scores to prostate biopsy (median score 9.11 vs 9.24), robotic simulator training (5.66 vs 5.93), on-call duties with consultants (6.85 vs 7.99), as well as all aspects of relational training (e.g., proper dialogue with colleagues: 7.95 vs 8.88). Conversely, residents assigned statistically significantly higher scores, albeit below sufficiency, to the performance of robotic prostatectomy as a first operator (4.45 vs 4.26). Finally, no discrepancies between residents' and tutors' scores were recorded regarding the remaining items of clinical training (e.g., urodynamics, outpatient clinic, ward duties) and surgical training (e.g., major open, laparoscopic and endoscopic surgical training; all p values >0.05).

CONCLUSIONS

There was partial concordance between trainees and tutors regarding the activities that should be implemented and the skills that should be achieved during a urological residency. The residents aimed for more surgical involvement, while the tutors and professors, although giving importance to surgical and theoretical training, considered clinical practice as the fundamental basis on which to train future urologists.

摘要

引言

泌尿外科住院医师培训项目结束时,学员应掌握能够独立工作及团队协作所需的最低技能。为实现这一目标,培训不仅应涵盖手术活动,还应包括理论、学术及人际关系方面的活动,这至关重要。在理想的泌尿外科培训中,这些活动之间的完美平衡是怎样的?本研究旨在评估不同视角(学员与教授)对良好泌尿外科培训不同概念的一致性。

材料与方法

2020年1月至12月期间,通过电子邮件向967名泌尿外科住院医师学员和泌尿外科导师发放了相同的调查问卷。该调查涵盖5个教育领域:理论、临床、手术、人际关系及模拟。针对每个领域,特定问题调查了不同活动的重要性以及住院医师应达成的被视为基本的培训成果。受访者通过10分制李克特量表对问题进行评估。

结果

来自26个不同国家的155名学员(58.9%,A组)和108名导师(41.1%,B组)完成了调查。相对于导师,学员对前列腺活检(中位数评分9.11对9.24)、机器人模拟器培训(5.66对5.93)、与顾问一起值夜班(6.85对7.99)以及人际关系培训的各个方面(例如与同事的恰当对话:7.95对8.88)给出的评分在统计学上显著更低。相反,学员对作为主刀医生进行机器人前列腺切除术的表现给出的评分在统计学上显著更高,尽管未达到充分水平(4.45对4.26)。最后,在临床培训(例如尿动力学、门诊、病房工作)和手术培训(例如大型开放手术、腹腔镜和内镜手术培训;所有p值>0.05)的其余项目上,未记录到学员和导师评分之间的差异。

结论

在泌尿外科住院医师培训期间应开展的活动以及应掌握的技能方面,学员和导师之间存在部分一致性。学员希望更多地参与手术,而导师和教授虽然重视手术和理论培训,但将临床实践视为培养未来泌尿外科医生的根本基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc4c/10357832/30a7b7278075/CEJU-76-19-g001.jpg

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